Citation Nr: 18141148 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 16-24 728 DATE: October 9, 2018 REMANDED Entitlement to service connection for right shoulder disability, as secondary to the service-connected disability of residuals, left shoulder strain, is remanded. Entitlement to service connection for sleep apnea is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1982 to June 2004. This matter comes before the Board of Veterans’ Appeals (Board) from February 2015 and November 2015 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for right shoulder disability, as secondary to the service-connected disability of residuals, left shoulder strain, is remanded. 2. Entitlement to service connection for sleep apnea is remanded. Upon review of the record, the Board finds that an additional medical opinion is needed with respect to the Veteran’s claimed right shoulder and sleep apnea disabilities. With respect to the claim for service connection for right shoulder disability, a January 2015 VA examiner provided a diagnosis of right shoulder impingement syndrome but did not provide an opinion as to whether the Veteran’s right shoulder condition was related to service or to his service-connected left shoulder disability. Therefore, an addendum opinion is needed. With respect to the claimed sleep apnea disability, an October 2015 VA examiner opined that the Veteran’s current sleep apnea was not caused by loud snoring and choking in service. However, the examiner did not address the question of whether any current sleep apnea disorder arose in service. Therefore, an addendum opinion is needed. Relevant ongoing medical records should also be requested. Finally, additional relevant evidence in the form of VA treatment records were associated with the claims file subsequent to the April 2016 Statement of the Case. However, no Supplemental Statement of the Case (SSOC) has been issued. See 38 C.F.R. § 20.1304(c). Therefore, an SSOC must be issued. Id. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed right shoulder and sleep apnea disabilities. After securing any necessary releases, request any relevant records identified that are not associated with the claims file. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran should be notified of such. 2. After records development is completed, send the claims file to a VA examiner to obtain an addendum opinion regarding the Veteran’s right shoulder claim. If a new examination is deemed necessary to respond to the questions presented, one should be scheduled. Following review of the claims file, the examiner should provide the following opinions: (a.) Is it at least as likely as not (50 percent probability or greater) that any current right shoulder disability is related to service? Please explain why or why not, to include the Veteran’s contention that his left shoulder caused to him overcompensate by using his right shoulder during vigorous military training. (b.) If not caused by service, is it at least as likely as not that the Veteran’s right shoulder condition was caused by his service-connected left shoulder strain? Please explain why or why not, to include addressing the contention that the right shoulder condition is due to overcompensating for the left shoulder. (c.) If not caused by the service-connected left shoulder disability, is it at least as likely as not that the Veteran’s right shoulder condition was worsened beyond natural progression (aggravated) by his service-connected disability of residuals of left shoulder strain? Please explain why or why not, to include addressing the contention that the right shoulder condition is due to overcompensating for the left shoulder. (d.) If the examiner finds that the Veteran’s right shoulder condition was aggravated by his service-connected disability of residuals of left shoulder strain, the examiner should attempt to quantify the level of aggravation beyond the baseline level of the right shoulder condition. A rationale for any opinion expressed should be provided. 3. Send the claims file to a VA examiner to obtain an addendum opinion regarding the Veteran’s sleep apnea claim. If a new examination is deemed necessary to respond to the question presented one should be scheduled. Following review of the claims file the examiner should opine whether it is at least as likely as not (50 percent or greater) that the current sleep apnea disability arose during service or is otherwise related to service? Please explain why or why not. The examiner is asked to consider the lay contentions of snoring and breathing problems during service. A rationale for any opinion expressed should be provided. 4. After completing the requested actions, and any additional action deemed necessary, readjudicate the claims. If the benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a supplemental statement of the case and given the opportunity to respond. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. C. Birder, Associate Counsel